Author of 2 Presentations
SS 6.5 - Feasibility and reliability of GI US in pregnant inflammatory bowel disease patients
Abstract
Purpose
Disease activity during pregnancy in women with inflammatory bowel disease (IBD) is associated with miscarriage and low birth weight. GIUS has a high potential for monitoring disease activity. The aim of this prospective study is to determine the feasibility and the reliability of GIUS in pregnant IBD patients.
Material and methods
Patients were included to the study when visiting the IBD pregnancy clinic. At each trimester, clinical and biochemical disease activity was evaluated and GIUS was performed. Feasibility was assessed by the ability to visualize each bowel segment (terminal ileum (TI), ascending, transverse, descending and sigmoid colon). Reliability was evaluated using fecal calprotectin (FCP) as the gold standard. Bowel wall thickness (BWT) of >3 mm in the colon and >2mm in the TI was considered as active inflammation on US.
Results
Thirty-two IBD patients were studied. Eleven of 32 patients had clinically active disease at least at one time point during the pregnancy. Visibility of TI and sigmoid declined from 85% and 95% in the first trimester to 22% and 45% in the third trimester, respectively. FCP levels were higher in patients with active disease on GIUS (mean 1095.5 ± 1453.8 mg/g vs 265.25 ± 649.8 mg/g, p<0.0001). When active, disease was defined as a FCP ≥ 250 mg/g, GIUS could distinguish active from non-active disease in the first, second and third trimesters with a sensitivity of 80%, 75% and 75% and specificity of 85%, 86% and 100%, respectively.
Conclusion
GIUS is feasible and reliable to assess disease activity throughout pregnancy in IBD.
Slides
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DEVOOGD SS 6.5 IUS in pregnant IBD ESGAR 2020 without recording Wed, 13.05.2020 13:47
Video-on-demand
SS 6.7 - Inter-observer agreement of an expert panel for GIUS in ulcerative colitis
Abstract
Purpose
GIUS is increasingly performed in inflammatory bowel disease to assess disease activity and treatment response. It correlates well with endoscopy and other cross-sectional imaging modalities. However, the reliability of GIUS has poorly been investigated for ulcerative colitis (UC). Therefore, we conducted a study to assess inter-observer agreement in UC.
Material and methods
Thirty patients with UC were included. Cine-loops were recorded for the sigmoid in a longitudinal and cross-sectional axis. Cine-loops were scored by five independent raters blinded for clinical disease activity. The cine-loops were scored for bowel wall thickness (BWT), Doppler activity (0=no signal, 1=small spots limited to the wall, 2=long stretches within the wall, 3=long stretches reaching into the mesenterium), inflammatory fat, bowel wall stratification, loss of haustration and lymph nodes (present or absent). Intraclass correlation coefficient, Fleiss’ kappa and weighted Cohen’s kappa were used for statistical analysis.
Results
Inter-observer agreement was good for bowel wall thickness (ICC: 0.7, 95% CI: 0.51-0.83) and moderate for Doppler signal (k=0.57, 95% CI: 0.37-0.77) and inflammatory fat (k=0.42, 95% CI: 0.29-0.58). When Doppler signal was interpreted as absent (0) or present (1-3), the observed agreement was almost perfect (k=0.81, 95% CI: 0.69-0.92). Agreement was fair for the presence of lymph nodes (k=0.35, 95% CI:0.20-0.49) and loss of stratification (k=0.22 95% CI: 0.09-0.35) and slight for loss of haustrations (k=0.15, 95% CI: 0.00-0.29).
Conclusion
GIUS is a reliable imaging modality with good-to-moderate inter-observer agreement for BWT, vascularization and fatty wrapping in UC. These ultrasonographic parameters are important features to distinguish active from quiescent disease.
Video-on-demand
Author of 2 Presentations
SS 6.5 - Feasibility and reliability of GI US in pregnant inflammatory bowel disease patients (ID 642)
Abstract
Purpose
Disease activity during pregnancy in women with inflammatory bowel disease (IBD) is associated with miscarriage and low birth weight. GIUS has a high potential for monitoring disease activity. The aim of this prospective study is to determine the feasibility and the reliability of GIUS in pregnant IBD patients.
Material and methods
Patients were included to the study when visiting the IBD pregnancy clinic. At each trimester, clinical and biochemical disease activity was evaluated and GIUS was performed. Feasibility was assessed by the ability to visualize each bowel segment (terminal ileum (TI), ascending, transverse, descending and sigmoid colon). Reliability was evaluated using fecal calprotectin (FCP) as the gold standard. Bowel wall thickness (BWT) of >3 mm in the colon and >2mm in the TI was considered as active inflammation on US.
Results
Thirty-two IBD patients were studied. Eleven of 32 patients had clinically active disease at least at one time point during the pregnancy. Visibility of TI and sigmoid declined from 85% and 95% in the first trimester to 22% and 45% in the third trimester, respectively. FCP levels were higher in patients with active disease on GIUS (mean 1095.5 ± 1453.8 mg/g vs 265.25 ± 649.8 mg/g, p<0.0001). When active, disease was defined as a FCP ≥ 250 mg/g, GIUS could distinguish active from non-active disease in the first, second and third trimesters with a sensitivity of 80%, 75% and 75% and specificity of 85%, 86% and 100%, respectively.
Conclusion
GIUS is feasible and reliable to assess disease activity throughout pregnancy in IBD.
Slides
-
DEVOOGD SS 6.5 IUS in pregnant IBD ESGAR 2020 without recording Wed, 13.05.2020 13:47
Video-on-demand
SS 6.7 - Inter-observer agreement of an expert panel for GIUS in ulcerative colitis (ID 748)
Abstract
Purpose
GIUS is increasingly performed in inflammatory bowel disease to assess disease activity and treatment response. It correlates well with endoscopy and other cross-sectional imaging modalities. However, the reliability of GIUS has poorly been investigated for ulcerative colitis (UC). Therefore, we conducted a study to assess inter-observer agreement in UC.
Material and methods
Thirty patients with UC were included. Cine-loops were recorded for the sigmoid in a longitudinal and cross-sectional axis. Cine-loops were scored by five independent raters blinded for clinical disease activity. The cine-loops were scored for bowel wall thickness (BWT), Doppler activity (0=no signal, 1=small spots limited to the wall, 2=long stretches within the wall, 3=long stretches reaching into the mesenterium), inflammatory fat, bowel wall stratification, loss of haustration and lymph nodes (present or absent). Intraclass correlation coefficient, Fleiss’ kappa and weighted Cohen’s kappa were used for statistical analysis.
Results
Inter-observer agreement was good for bowel wall thickness (ICC: 0.7, 95% CI: 0.51-0.83) and moderate for Doppler signal (k=0.57, 95% CI: 0.37-0.77) and inflammatory fat (k=0.42, 95% CI: 0.29-0.58). When Doppler signal was interpreted as absent (0) or present (1-3), the observed agreement was almost perfect (k=0.81, 95% CI: 0.69-0.92). Agreement was fair for the presence of lymph nodes (k=0.35, 95% CI:0.20-0.49) and loss of stratification (k=0.22 95% CI: 0.09-0.35) and slight for loss of haustrations (k=0.15, 95% CI: 0.00-0.29).
Conclusion
GIUS is a reliable imaging modality with good-to-moderate inter-observer agreement for BWT, vascularization and fatty wrapping in UC. These ultrasonographic parameters are important features to distinguish active from quiescent disease.